Comparison of clinical outcome between surgical treatment and particle beam therapy for pelvic bone sarcomas: A retrospective multicenter study in Japan

• DOI: 10.1016/j.jos.2024.06.007
• Publication Date: 2024-07-03T15:58:06Z
• Authors: Toshiyuki Takemori; Hitomi Hara; Teruya Kawamoto; Naomasa Fukase; Ryoko Sawada; Shuichi Fujiwara; Ikuo Fujita; Takuya Fujimoto; Masayuki Morishita; Shunsuke Yahiro; Tomohiro Miyamoto; Masanori Saito; Jun Sugaya; Katsuhiro Hayashi; Hiroyuki Kawashima; Tomoaki Torigoe; Tomoki Nakamura; Hiroya Kondo; Toru Wakamatsu; Munenori Watanuki; Munehisa Kito; Satoshi Tsukushi; Akihito Nagano; Hidetatsu Outani; Shunichi Toki; Shunji Nishimura; Hiroshi Kobayashi; Itsuo Watanabe; Yusuke Demizu; Ryohei Sasaki; Takumi Fukumoto; Tomoyuki Matsumoto; Ryosuke Kuroda; Toshihiro Akisue

Few studies have compared the clinical outcomes of patients with pelvic bone sarcomas treated surgically and those treated with particle beam therapy. This is a multicenter retrospective cohort study which compared the clinical outcomes of patients with pelvic bone sarcoma who underwent surgical treatment and particle beam therapy in Japan.A total of 116 patients with pelvic bone sarcoma treated at 19 specialized sarcoma centers in Japan were included in this study. Fifty-seven patients underwent surgery (surgery group), and 59 patients underwent particle beam therapy (particle beam group; carbon-ion radiotherapy: 55 patients, proton: four patients).The median age at primary tumor diagnosis was 52 years in the surgery group and 66 years in the particle beam group (P < 0.001), and the median tumor size was 9 cm in the surgery group and 8 cm in the particle beam group (P = 0.091). Overall survival (OS), local control (LC), and metastasis-free survival (MFS) rates were evaluated using the Kaplan-Meier method and compared among 116 patients with bone sarcoma (surgery group, 57 patients; particle beam group, 59 patients). After propensity score matching, the 3-year OS, LC, and MFS rates were 82.9% (95% confidence interval [CI], 60.5-93.2%), 66.0% (95% CI, 43.3-81.3%), and 78.4% (95% CI, 55.5-90.5%), respectively, in the surgery group and 64.9% (95% CI, 41.7-80.8%), 86.4% (95% CI, 63.3-95.4%), and 62.6% (95% CI, 38.5-79.4%), respectively, in the particle beam group. In chordoma patients, only surgery was significantly correlated with worse LC in the univariate analysis.The groups had no significant differences in the OS, LC, and MFS rates. Among the patients with chordomas, the 3-year LC rate in the particle beam group was significantly higher than in the surgery group.